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General NPI Number Information
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NPI Number | 1326749367
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Entity Type | Individual
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Provider Name | NADIA HRYNEWYCZ
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Gender | Female
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 5970 CHURVIEW DR.
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City | ROCKFORD
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State | IL
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Zip | 61107
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Country | US
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Telephone | 815-971-9978
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Fax |
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Provider Business Mailing Address
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Address Line | 1858 W GRANDVIEW BLVD
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City | ERIE
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State | PA
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Zip | 16509-1025
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.084448
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License Number State | IL
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